Selection criteria Flashcards
(42 cards)
What is it important to remember when taking X-rays?
They are a 2D representation of a 3D structure (need views from other angles and what we already know needs to be applied)
What are the main indications for bite wings?
Detection of dental caries
Monitoring the progression of dental caries
Assessment of existing restorations
Assessment if periodontal status of pocket depths up to 6 mm using vertical bitewing
Caries diagnosis and radiographs:
Screening for interdental caries (not clinically evident)
Posterior bite wings increase diagnostic yield of inter-proximal lesions X4 compared to clinical examination
Needs 50% demineralisation before you can visualise caries radio graphically
Need good contrast between enamel and dentine to detect caries (lower kV gives better contrast)
N.b. Various lesions are always larger clinically than they appear on X-rays
Periodontal and radiographs:
Needs less contrast than caries diagnosis (uses higher kV - just over 70)
How often should you take posterior bite wings for caries diagnosis?
High caries risk: 6 monthly
Moderate caries risk: annually (but if start to see caries they become high caries risk)
Low caries risk: 12-18 months (primary dentition) and 24 months (permanent dentition)
What is the recommendations by the European Association of paediatric dentistry?
Radiographs should be taken only if considered necessary for adequate treatment
5 y/o should be considered although cooperation may be poor
8-9 y/o
12-14 y/o = 1-2 yrs after eruption of premolars and second molars
What is the recommended interval for children age 5 at baseline bitewing exam?
Low caries risk 3 years
High caries risk 1 year
What is the recommended interval for children age 8-9 at baseline bitewing exam?
Low caries risk 3-4 years
High caries risk 1 year
What is the recommended interval for children age 12-14 at baseline bitewing exam?
Low caries risk: 2 years
High caries risk: 1 year
What is the recommended interval for children age 16 at baseline bitewing exam?
Low caries risk: 3 years
High caries risk: 1 year
When are periapical radiographs indicated/ required?
Root/ pupal pathology or development
Extent of crown pathology in anterior teeth
Assessment of apical pathology
Assessment of local anatomy including tooth development
What are the two techniques used to take periapical radiographs?
- Long cone paralleling (used wherever possible)
2. Bisecting angle
What are the different types of occlusal radiographs?
- upper standard (nasal occlusal) = large bisected angle periapical
- upper oblique occlusal
- lower 90 degree occlusal
- lower 45 degree occlusal = large bisected angle periapical
- lower oblique occlusal
When is taking a upper standard occlusal indicated?
When unable to take periapical
Trauma
Palatal pathology
2nd view to aid localisation
When us an upper oblique occlusal indicated?
When unable to take bitewing/ periapical
To provide view from different angle
When is a lower 90 degree occlusal indicated?
Reduced exposure for salivary calculus
Fractures of the anterior mandible
Buccolinguallu expansion of cortical bone
Localisation
When is a Lower 45 degree occlusal indicated?
Unable to tolerate periapical film
Lesion too large to visualise on intraoral film
Anterior fracture of the mandible
When is a lower oblique occlusal indicated?
Cannot tolerate periapical film
Imaging submandibular gland
What are the selection criteria for radiograph types for periodontal assessment?
Diagnosis of periodontal disease depends on clinical exam Requires reproducibility (assess changes in bone levels) Utilise radiographs taken to assess caries already
What are the uses of radiographs in periodontal assessment?
Determine bone loss and furcation involvement
Determine presence of causative factors (overhanging restoration margins)
Assist in treatment if planning
Evaluation of treatment
What are the guidelines for radiography in periodontal disease?
- uniform pocketing 4-5 mm (BPE Max 3)with little or no recession use horizontal bite wings
- pocketing 6mm+ (BPE 4) = vertical bite wings +/- paralleling technique periapicals
- irregular pocketing = bite wings (horizontal/vertical) +/- paralleling technique periapicals
Why would you not use DPT’s /CBCT for periodontal disease?
Distorts levels of bone I.e. DPT beam aimed up = lower looks like less bone than there is
When should you use paralleling technique periapicals?
If a Perio/endo lesion is suspected
= lower dose but takes longer
When should you radiograph in endodontics?
Preoperatively:
- at least 1 to determine working lengths unless other reliable means available (if preset file is >2mm from the radio graphic apex it is advisable to reset the file and retake the radiograph)
Operative:
- immediately following obturation (treatment) = baseline and quality
Post-operative:
- a symptomatic teeth = 1 year after completion of root filling and 4 years after completion of treatment
